Neurological manifestations of phaeochromocytomas and secretory paragangliomas: a reappraisal
| Autor: | Neil E Anderson, Michael S Croxson, Kong Chung, Ernie Willoughby |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Adrenal Gland Neoplasms Pheochromocytoma Paraganglioma Young Adult Epilepsy Pregnancy medicine Humans Retroperitoneal Neoplasms Child Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Cranial nerves Headache Middle Aged medicine.disease Reversible cerebral vasoconstriction syndrome Cerebral Angiography Psychiatry and Mental health Cardiovascular Diseases Head and Neck Neoplasms Anesthesia Acute Disease Hypertension Delirium Female Surgery Epilepsy Tonic-Clonic Neurology (clinical) Nervous System Diseases Headaches medicine.symptom business Pregnancy Complications Neoplastic Magnetic Resonance Angiography Cerebral vasculitis Cerebral angiography |
| Zdroj: | Journal of Neurology, Neurosurgery & Psychiatry. 84:452-457 |
| ISSN: | 0022-3050 |
| DOI: | 10.1136/jnnp-2012-303028 |
| Popis: | Objective To determine the frequency and range of neurological manifestations of phaeochromocytomas and secretory paragangliomas. Methods A retrospective review of case notes of patients admitted to Auckland Hospital from 1985 to 2011 with a discharge diagnosis of phaeochromocytoma or secretory paraganglioma. Results Ninety-three patients were admitted with a phaeochromocytoma or secretory paraganglioma. Sixty-eight patients (73%) had neurological symptoms, but only 15 patients (16%) received a neurological consultation. Neurological manifestations occurred in three main clinical contexts. First, paroxysmal symptoms occurred in 66 of 93 patients (71%). Neurological symptoms were common features of these attacks and included headache (47 patients), anxiety (24 patients), tremulousness (15 patients) and dizziness (12 patients). The headaches typically had an explosive onset. Delay in diagnosis was common. Second, 28 patients (30%) had an acute crisis, which was associated with neurological symptoms in 11 (39%) of the episodes: headache (10 patients); seizures (five patients); strokes (three patients); delirium (three patients) and subarachnoid haemorrhage (one patient). Third, five of six patients with a head and neck secretory paraganglioma had neurological symptoms related to infiltration of the middle ear or compression of cranial nerves. Reversible cerebral vasoconstriction syndrome (RCVS) was documented in three patients. Conclusions Neurological manifestations of phaeochromocytomas and secretory paragangliomas were common, and these tumours can present with various neurological manifestations. The paroxysmal symptoms can be incorrectly attributed to other headache syndromes, panic attacks or cerebral vasculitis. RCVS may play a role in the pathogenesis of the neurological symptoms associated with acute crises and paroxysmal attacks. |
| Databáze: | OpenAIRE |
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